Our Stories Rx

"PBMs will be limited to bona fide service fees, defined as fair-market-value payments for itemized services actually performed and not passed through to a client."

New reforms are coming: https://www.pharmacytimes.com/view/the-pbm-reform-clock-is-running-to-2028-here-s-what-independent-pharmacies-should-do

"Left unchecked, these soaring costs, along with other pressures driving up healthcare spending, will force some small companies to cut healthcare benefits and deprive others of the capital they need to hire and grow."

Protect patient access: https://www.washingtontimes.com/news/2026/sep/8/soaring-healthcare-costs-killing-small-businesses/

"Arkansas passed the first law barring PBMs from owning pharmacies; Tennessee followed this spring. The PBMs sued both...the legislature’s underlying judgment was sound: you can be the benefit manager or the pharmacy, not both."

https://washingtonreporter.news/op-ed-joel-thayer-the-drug-middlemen-settled-but-the-conflict-of-interest-remains/

"Eight state actions in three years, targeting the same three PBM-affiliated GPOs.

When the same pattern shows up across states and courtrooms, it stops being a coincidence and starts being a business model."

GPO PAPER TRAIL: Eight States, One Pattern From Ohio to Delaware, state attorneys general and auditors are finding the same thing. Different courts, different contracts, same playbook.Eight state actions in three years, targeting the same three PBM-affiliated GPOs. When the same pattern shows up across states and courtrooms, it stops being a...

"Now among the most consequential parts of vertically integrated insurers, GPOs add another layer of value extraction on top of PBMs' rebates and spread pricing, but with even less visibility."

https://www.pbmaccountability.org/post/gpo-paper-trail-the-contract-you-can-t-read-because-it-s-overseas

"In 2025, U.S. net spending on outpatient prescription drugs was 9% of national health expenditures, but 26% of adults said they or someone in their household had difficulty paying for prescription drugs. Only 11% said the same about medical bills."

Drug Channels

"No matter where excess costs initially land — patients, health plans, employers, or the government — they ultimately come out of our pockets.

The controversy is a perfect example."

All Hat, No Cattle: When Urban Hospitals Pretend to be Rural Why would a large urban hospital want to be considered rural?

: Federal reform efforts are back in this fall.

Read more: https://www.ajmc.com/view/senate-unveils-sweeping-bill-to-reform-340b-drug-program

"Medical innovations, such as the skin cancer vaccine, are being created in spite of the political class, not because of it."

benefit from competitive research environments: https://www.washingtonpost.com/opinions/2026/08/21/moderna-cancer-vaccine-is-thanks-free-market/

A fantastic recap of the state of reform in 2026 and what is possible in terms of protections at the state level: https://www.amcp.org/blog/5-states-driving-pbm-reform-2026